Brain Stimulation最新文献

{"title":"Where is the exit? The ethical importance of exit plans in clinical trials with neural implants","authors":"Franziska Britta Schönweitz ,&nbsp;Anja Kathrin Ruess ,&nbsp;Stuart McLennan ,&nbsp;Alena Buyx ,&nbsp;Marcello Ienca","doi":"10.1016/j.brs.2024.09.010","DOIUrl":"10.1016/j.brs.2024.09.010","url":null,"abstract":"<div><h3>Background</h3><div>As clinical trials involving implantable neural devices (INDs) increase in frequency and attract greater public attention, it is paramount to ensure they are conducted in alignment with fundamental ethical guidelines. Particular focus must be placed on the often underexplored aspect of trial termination for INDs.</div></div><div><h3>Objective</h3><div>To systematically review the ethical challenges encountered in clinical trials for INDs at the juncture of trial termination.</div></div><div><h3>Methods</h3><div>We conducted a rapid review using PubMed with two specific search queries, including all publications addressing ethical issues in the context of IND clinical trials. Priority was given to publications focusing on the end of treatment or the discontinuation of clinical studies or trials.</div></div><div><h3>Results</h3><div>We identified three primary groups of ethical challenges: patient-centric challenges, challenges faced by the research and physician team, and manufacturer-related issues. Further analysis highlights the importance of initiating early, transparent discussions regarding trial cessation protocols, ensuring that all stakeholders—patients, healthcare providers, researchers, and manufacturers—are equitably considered. Additionally, we found a discrepancy between current discontinuation strategies and international ethical guidelines. To address this, we emphasize the ethical obligation to establish comprehensive exit strategies that align with the principles in the Declaration of Helsinki and the CIOMS/WHO guidelines.</div></div><div><h3>Conclusion</h3><div>Our findings highlight the need for increased attention to the ethical and practical aspects of exit strategies and encourage further empirical research to address gaps in current practices. This would ensure that the discontinuation of IND trials is handled with ethical rigor, prioritizing the interests and well-being of all stakeholders involved.</div></div>","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":"17 5","pages":"Pages 1145-1154"},"PeriodicalIF":7.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142341930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thalamic transcranial ultrasound stimulation in treatment resistant depression","authors":"Joline M. Fan,&nbsp;Kai Woodworth,&nbsp;Keith R. Murphy,&nbsp;Leighton Hinkley,&nbsp;Joshua L. Cohen,&nbsp;Joanne Yoshimura,&nbsp;Inhauck Choi,&nbsp;Alexandra G. Tremblay-McGaw,&nbsp;Joncarmen Mergenthaler,&nbsp;Cameron H. Good,&nbsp;Peter A. Pellionisz,&nbsp;A.Moses Lee,&nbsp;Tommaso Di Ianni,&nbsp;Leo P. Sugrue,&nbsp;Andrew D. Krystal","doi":"10.1016/j.brs.2024.08.006","DOIUrl":"10.1016/j.brs.2024.08.006","url":null,"abstract":"","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":"17 5","pages":"Pages 1001-1004"},"PeriodicalIF":7.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1935861X24001475/pdfft?md5=c49533fc33c6274921bdc4bbdf1f4230&pid=1-s2.0-S1935861X24001475-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acoustic deep brain modulation: Enhancing neuronal activation and neurogenesis","authors":"Hwichan Ham ,&nbsp;Kyu Sik Kim ,&nbsp;Jee-Hwan Lee ,&nbsp;Do-Nyun Kim ,&nbsp;Hyung-Jin Choi ,&nbsp;Jack J. Yoh","doi":"10.1016/j.brs.2024.08.012","DOIUrl":"10.1016/j.brs.2024.08.012","url":null,"abstract":"<div><h3>Background</h3><p>Non-invasive deep brain modulation (DBM) stands as a promising therapeutic avenue to treat brain diseases. Acoustic DBM represents an innovative and targeted approach to modulate the deep brain, employing techniques such as focused ultrasound and shock waves. Despite its potential, the optimal mechanistic parameters, the effect in the brain and behavioral outcomes of acoustic DBM remains poorly understood.</p></div><div><h3>Objective</h3><p>To establish a robust protocol for the shock wave DBM by optimizing its mechanistic profile of external stimulation, and to assess its efficacy in preclinical settings.</p></div><div><h3>Methods</h3><p>We used shockwaves due to their capacity to leverage a broader spectrum of peak intensity (10–127 W/mm²) in contrast to ultrasound (0.1–5.0 W/mm²), thereby enabling a more extensive range of neuromodulation effects. We established various types of shockwave pressure profiles of DBM and compared neural and behavioral responses. To ascertain the anticipated cause of the heightened neural activity response, numerical analysis was employed to examine the mechanical dynamics within the brain.</p></div><div><h3>Results</h3><p>An optimized profile led to an enhancement in neuronal activity within the hypothalamus of mouse models. The optimized profile in the hippocampus elicited a marked increase in neurogenesis without neuronal damage. Behavioral analyses uncovered a noteworthy reduction in locomotion without significant effects on spatial memory function.</p></div><div><h3>Conclusions</h3><p>The present study provides an optimized shock wave stimulation protocol for non-invasive DBM. Our optimized stimulation profile selectively triggers neural functions in the deep brain. Our protocol paves the way for new non-invasive DBM devices to treat brain diseases.</p></div>","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":"17 5","pages":"Pages 1060-1075"},"PeriodicalIF":7.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1935861X24001530/pdfft?md5=1a24b63a995cebb49b792cc6bde1ed5b&pid=1-s2.0-S1935861X24001530-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transient alteration of Awareness triggered by direct electrical stimulation of the brain","authors":"Julie Lévi-Strauss ,&nbsp;Julia Makhalova ,&nbsp;Samuel Medina Villalon ,&nbsp;Romain Carron ,&nbsp;Christian G. Bénar ,&nbsp;Fabrice Bartolomei","doi":"10.1016/j.brs.2024.08.013","DOIUrl":"10.1016/j.brs.2024.08.013","url":null,"abstract":"<div><h3>Background</h3><p>Awareness is a state of consciousness that enables a subject to interact with the environment. Transient alteration of awareness (AA) is a disabling sign of many types of epileptic seizures. The brain mechanisms of awareness and its alteration are not well known.</p></div><div><h3>Objective/Hypothesis</h3><p>Transient and isolated AA induced by electrical brain stimulation during a stereoelectroencephalography (SEEG) recording represents an ideal model for studying the associated modifications of functional connectivity and locating the hubs of awareness networks.</p></div><div><h3>Methods</h3><p>We investigated the SEEG signals-based brain functional connectivity (FC) changes vs background occurring during AA triggered by three thalamic and two insular stimulations in three patients explored by SEEG in the frame of presurgical evaluation for focal drug-resistant epilepsy. The results were compared to the stimulations of the same sites that did not induce clinical changes (negative stimulations).</p></div><div><h3>Results</h3><p>We observed decreased node strength in the pulvinar, insula, and parietal associative cortices during the thalamic and insular stimulations that induced AA. The link strengths characterizing functional coupling between the thalamus and the insular, prefrontal, temporal, or parietal associative cortices were also decreased. In contrast, there was an increased synchronization between the precuneus and the temporal lateral cortex. These FC changes were absent during the negative stimulations.</p></div><div><h3>Conclusion</h3><p>Our study highlights the role of the pulvinar, insular, and parietal hubs in maintaining the awareness networks and paves the way for invasive or non-invasive neuromodulation protocols to reduce AA manifestations during epileptic seizures.</p></div>","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":"17 5","pages":"Pages 1024-1033"},"PeriodicalIF":7.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1935861X24001542/pdfft?md5=ab805e1122237ec8c74b20c7571fdfe0&pid=1-s2.0-S1935861X24001542-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accelerated deep TMS in alcohol use disorder: A preliminary pilot trial targeting the dorsal anterior cingulate cortex increases neural target engagement and abstinence","authors":"Claudia B. Padula ,&nbsp;Lea-Tereza Tenekedjieva ,&nbsp;Daniel M. McCalley,&nbsp;Jairelisse Morales Morales,&nbsp;Michelle R. Madore","doi":"10.1016/j.brs.2024.09.002","DOIUrl":"10.1016/j.brs.2024.09.002","url":null,"abstract":"","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":"17 5","pages":"Pages 1098-1100"},"PeriodicalIF":7.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1935861X24001566/pdfft?md5=4e2073e3cf1b59f2ac8b6fc6d3275bc0&pid=1-s2.0-S1935861X24001566-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategies to mitigate scalp discomfort during repetitive transcranial magnetic stimulation","authors":"Jennifer I. Lissemore,&nbsp;Derrick M. Buchanan,&nbsp;Jean-Marie Batail,&nbsp;Irakli Kaloiani,&nbsp;Clive Veerapal,&nbsp;Gregory L. Sahlem,&nbsp;Nolan R. Williams","doi":"10.1016/j.brs.2024.09.004","DOIUrl":"10.1016/j.brs.2024.09.004","url":null,"abstract":"","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":"17 5","pages":"Pages 1131-1133"},"PeriodicalIF":7.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1935861X2400158X/pdfft?md5=ce09f7224f4628bd4d8ecca8ce4b012c&pid=1-s2.0-S1935861X2400158X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142272710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How conductivity boundaries influence the electric field induced by transcranial magnetic stimulation in in vitro experiments","authors":"Padmavathi Sundaram ,&nbsp;Chunling Dong ,&nbsp;Sergey Makaroff ,&nbsp;Yoshio Okada","doi":"10.1016/j.brs.2024.08.003","DOIUrl":"10.1016/j.brs.2024.08.003","url":null,"abstract":"<div><h3>Background</h3><p>Although transcranial magnetic stimulation (TMS) has become a valuable method for non-invasive brain stimulation, the cellular basis of TMS activation of neurons is still not fully understood. <em>In vitro</em> preparations have been used to understand the biophysical mechanisms of TMS, but in many cases these studies have encountered substantial difficulties in activating neurons.</p></div><div><h3>Objective/hypothesis</h3><p>The hypothesis of this work is that conductivity boundaries can have large effects on the electric field in commonly used <em>in vitro</em> preparations. Our goal was to analyze the resulting difficulties in <em>in vitro</em> TMS using a simulation study, using a charge-based boundary element model.</p></div><div><h3>Methods</h3><p>We decomposed the total electric field into the sum of the primary electric field, which only depends on coil geometry and current, and the secondary electric field arising from conductivity boundaries, which strongly depends on tissue and chamber geometry. We investigated the effect of the conductivity boundaries on the electric field strength for a variety of <em>in vitro</em> experimental settings to determine the sources of difficulty.</p></div><div><h3>Results</h3><p>We showed that conductivity boundaries can have large effects on the electric field in in vitro preparations. Depending on the geometry of the air-saline and the saline-tissue interfaces, the secondary electric field can significantly enhance, or attenuate the primary electric field, resulting in a much stronger or weaker total electric field inside the tissue; we showed this using a realistic preparation. Submerged chambers are generally much more efficient than interface chambers since the secondary field due to the thin film of saline covering the tissue in the interface chamber opposes the primary field and significantly reduces the total field in the tissue placed in the interface chamber. The relative dimensions of the chamber and the TMS coil critically determine the total field; the popular setup with a large coil and a small chamber is particularly sub-optimal because the secondary field due to the air-chamber boundary opposes the primary field, thereby attenuating the total field. The form factor (length vs width) of the tissue in the direction of the induced field can be important since a relatively narrow tissue enhances the total field at the saline-tissue boundary.</p></div><div><h3>Conclusions</h3><p>Overall, we found that the total electric field in the tissue is higher in submerged chambers, higher if the chamber size is larger than the coil and if the shorter tissue dimension is in the direction of the electric field. Decomposing the total field into the primary and secondary fields is useful for designing <em>in vitro</em> experiments and interpreting the results.</p></div>","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":"17 5","pages":"Pages 1034-1044"},"PeriodicalIF":7.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1935861X24001402/pdfft?md5=d2bf92663a048e0444cdf459d4ff06cc&pid=1-s2.0-S1935861X24001402-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141919217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Organotypic culture of post-mortem adult human brain explants exhibits synaptic plasticity","authors":"Yukiko Iwasaki ,&nbsp;Corentin Bernou ,&nbsp;Barbara Gorda ,&nbsp;Sophie Colomb ,&nbsp;Gowrishankar Ganesh ,&nbsp;Raphael Gaudin","doi":"10.1016/j.brs.2024.08.010","DOIUrl":"10.1016/j.brs.2024.08.010","url":null,"abstract":"<div><h3>Background</h3><p>Synaptic plasticity is an essential process encoding fine-tuned brain functions, but models to study this process in adult human systems are lacking.</p></div><div><h3>Objective</h3><p>We aim to test whether <em>ex vivo</em> organotypic culture of <em>post-mortem</em> adult brain explants (OPABs) retain synaptic plasticity.</p></div><div><h3>Methods</h3><p>OPABs were seeded on 3D microelectrode arrays to measure local field potential (LFP). Paired stimulation of distant electrodes was performed over three days to investigate our capacity to modulate specific neuronal connections.</p></div><div><h3>Results</h3><p>Long-term potentiation (LTP) or depression (LTD) did not occur within a single day. In contrast, after two and three days of training, OPABs showed a significant modulation of the paired electrodes’ response compared to the non-paired electrodes from the same array. This response was alleviated upon treatment with dopamine.</p></div><div><h3>Conclusion</h3><p>Our work highlights that adult human brain explants retain synaptic plasticity, offering novel approaches to neural circuitry in animal-free models.</p></div>","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":"17 5","pages":"Pages 1018-1023"},"PeriodicalIF":7.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1935861X24001517/pdfft?md5=78b4072b693d4ee334322844bbe9ae18&pid=1-s2.0-S1935861X24001517-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic labeling of the nucleus of tractus solitarius neurons associated with electrical stimulation of the cervical or auricular vagus nerve in mice","authors":"Md Sams Sazzad Ali ,&nbsp;Ghazaal Parastooei ,&nbsp;Swarnalakshmi Raman ,&nbsp;Jalen Mack ,&nbsp;Yu Shin Kim ,&nbsp;Man-Kyo Chung","doi":"10.1016/j.brs.2024.08.007","DOIUrl":"10.1016/j.brs.2024.08.007","url":null,"abstract":"<div><h3>Introduction</h3><p>Vagus nerve stimulation (VNS) is clinically useful for treating epilepsy, depression, and chronic pain. Currently, cervical VNS (cVNS) treatment is well-established, while auricular VNS (aVNS) is under development. Vagal stimulation regulates functions in diverse brain regions; therefore, it is critical to better understand how electrically-evoked vagal inputs following cVNS and aVNS engage with different brain regions.</p></div><div><h3>Objective</h3><p>As vagus inputs are predominantly transmitted to the nucleus of tractus solitarius (NTS), we directly compared the activation of NTS neurons by cVNS or aVNS and the brain regions directly projected by the activated NTS neurons in mice.</p></div><div><h3>Methods</h3><p>We adopted the targeted recombination in active populations method, which allows for the activity-dependent, tamoxifen-inducible expression of mCherry—a reporter protein—in neurons specifically associated with cVNS or aVNS.</p></div><div><h3>Results</h3><p>cVNS and aVNS induced comparable bilateral mCherry expressions in neurons within the NTS, especially in its caudal section (cNTS). However, the numbers of mCherry-expressing neurons within different subdivisions of cNTS was distinctive. In both cVNS and aVNS, anterogradely labeled mCherry-expressing axonal terminals were similarly observed across different areas of the forebrain, midbrain, and hindbrain. These terminals were enriched in the rostral ventromedial medulla, parabrachial nucleus, periaqueductal gray, thalamic nuclei, central amygdala, and the hypothalamus. Sex difference of cVNS- and aVNS-induced labeling of NTS neurons was modest.</p></div><div><h3>Conclusion</h3><p>The central projections of mCherry-expressing cNTS terminals are comparable between aVNS and cVNS, suggesting that cVNS and aVNS activate distinct but largely overlapping projections into the brain through the cNTS.</p></div>","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":"17 5","pages":"Pages 987-1000"},"PeriodicalIF":7.6,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1935861X24001487/pdfft?md5=d254ac45e846a22c61872ecb8827d3f9&pid=1-s2.0-S1935861X24001487-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic reorganization of the somatomotor network in multiple sclerosis - Evidence from edge-centric functional connectivity analysis","authors":"Gabriel Gonzalez-Escamilla,&nbsp;Vinzenz Fleischer,&nbsp;Neus Mongay-Ochoa,&nbsp;Maren Person,&nbsp;Marie Martschenko,&nbsp;Dumitru Ciolac,&nbsp;Angela Radetz,&nbsp;Yaroslav Winter,&nbsp;Julia Schiffer,&nbsp;Felix Luessi,&nbsp;Marianne Hahn,&nbsp;Stefan Bittner,&nbsp;Frauke Zipp,&nbsp;Sven Meuth,&nbsp;Sergiu Groppa","doi":"10.1016/j.brs.2024.08.005","DOIUrl":"10.1016/j.brs.2024.08.005","url":null,"abstract":"","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":"17 5","pages":"Pages 980-982"},"PeriodicalIF":7.6,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1935861X24001463/pdfft?md5=71c520aafbd30bfc2fe65f0144636379&pid=1-s2.0-S1935861X24001463-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}